Provider Demographics
NPI:1013182161
Name:C & C LIFE INC.
Entity Type:Organization
Organization Name:C & C LIFE INC.
Other - Org Name:ACT WELLNESS CENTER BY ACCREDITED CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARATOZZOLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-590-8182
Mailing Address - Street 1:4431 OCCOQUAN OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6107
Mailing Address - Country:US
Mailing Address - Phone:703-590-8182
Mailing Address - Fax:703-590-4422
Practice Address - Street 1:14111 MINNIEVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-2312
Practice Address - Country:US
Practice Address - Phone:703-491-9355
Practice Address - Fax:703-490-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08515Medicare PIN